By David M. Greenwald
Yolo County DA Jeff Reisig last week put forward a five-point plan to reduce homelessness. While it contains some reasonable suggestions, the first plank is problematic and would require legislative action that under current conditions is highly unlikely. In addition, the plan in general suffers from a prosecutor’s rather than legislator’s mentality, which sees homelessness as combated through enforcement rather than the provision of services and treatment.
“Homelessness is an exploding humanitarian crisis affecting almost every community in California. Too many people suffering from severe mental illness and crippling addiction are being allowed to languish in filth and perish on our streets from disease, overdose and violence,” Reisig writes. “They need help.”
He argues: “Meanwhile, the quality of life for all Californians has dramatically declined as the crime and despair associated with the crisis has seeped across our state. There are real potential solutions to this crisis. They are not easy and they are not cheap. But, if California ever hopes to turn the tide, dramatic action is required.”
His five-point plan, he acknowledges, will “require groundbreaking legislation, funding and commitment from leaders and communities.”
- Amend California law to mandate state-funded treatment for seriously addicted drug users, including involuntary residential treatment, when appropriate.
- Expand conservatorship laws – make it easier to allow the seriously mentally ill and addicted to be conserved by loved ones and health professionals.
- Establish permanent drug courts and mental health courts in every county, where judges can collaborate with health professionals and all the parties to oversee a comprehensive treatment
and rehabilitation plan. - Build addiction and mental health facilities that can serve as secure treatment focused sanctuaries, not jails or prisons.
- Develop a statewide chain of drop-in-centers to provide free ongoing support and Medication-Assisted Treatment (MAT) to those on the path to recovery.
While some of these are reasonable goals, the first one is problematic at best.
The press release includes sample legislation which appeared to be a March 2020 amendment to AB 2804. They argue: “These addictions are best treated by residential and professionally conducted treatment programs,” but note that laws such as Prop. 47 and Prop. 36 (2000) “have removed temporary confinement for many of the most common drug offenses.”
It argues: “Temporary confinement is often an effective step in helping those suffering from a drug addiction to succeed in a drug treatment program.”
Given that, it would seem likely that such a move would require the voters to amend Prop. 47—that the legislature probably could not do that itself.
This follows in line with the DA’s complaint about Prop. 47 in which it eliminates the stick approach to compelling people to undertake drug treatment. But do these approaches work? Many would argue that they have not.
Beyond that there is a large problem with the proposal—it is an enforcement-based model. They talk about things like drug courts and mental health courts which are indeed improvements over the previous system, but they still require the individual to actually enter into the legal system in the first place. There is in fact nothing here that seeks to intervene prior to entrance into the legal system. That represents a huge barrier to this plan being a comprehensive solution.
For people suffering from mental illness, that means they must have broken laws in order to enter the system. For people suffering from drug addiction, this still relies on criminal sanctions and threats rather than a purely public health approach.
Moreover, most of this deals with the back end of addiction and mental health crisis, once people have gotten to the point where they come in contact with the criminal legal system. That is not surprising, given that it is a district attorney putting forward these proposals.
There is nothing here about education. Nothing here about job training. Nothing here about access to affordable housing. These omissions mean that someone effectively has to break the law before these reforms will make any difference rather than attempting to prevent drug addiction, prevent mental health crises, prevent homelessness in the first place.
There is a clear need to deal with these issues at this stage, and this proposal largely avoids the need for jails and prisons for low level drug offenses and for mental health related offenses, but it is limited to the back end. And it also does not have many mechanisms to prevent recidivism.
This is a problem because, even if what they propose to happen works, where do people end up once they are released from court-ordered facilities? Sure, they have free ongoing support and drop-in centers, but nothing to allow them to build their lives, nothing to allow people to get quality jobs, no place for people to stay once they have cleaned up—if they do.
In short, while this is a midway path toward legal reform, pushing people from strict punishment-based approaches to treatment-based approaches, it falls well-short of any kind of comprehensive approach to homelessness.
It gets people who are addicted to drugs out of prisons and jails, which is a good thing, but it keeps them in the criminal legal system—which is probably not the best place for them, and it waits until they enter that system before setting up these approaches.
—David M. Greenwald reporting
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It’s not surprising that the DA’s recommendations would so heavily rely on coercive, involuntary forms of intervention.
Mandated state-funded treatment is needed, including “a statewide chain of drop-in-centers to provide free ongoing support and Medication-Assisted Treatment (MAT).” However, involuntary residential treatment beyond what is currently authorized should not be considered as long as voluntary alternatives are not available.
Conservatorship expansion is simply another means of expanding involuntary treatment. Aside from the civil liberties implications and the fact that coerced, involuntary treatment is less effective than voluntary treatment, unless and until voluntary treatment and affordable housing options, including supportive housing with wraparound services, are made available, this recommendation, like the prior one, is unwarranted.
I’m not sure what “secure” treatment means. But, if it’s another term for involuntary treatment, it has the same implications as other forms of coerced treatment and involuntary confinement.
Of course, the devil will be in the details with each of these recommendations, but the overall description appears to entail steps in the wrong direction and is not encouraging.
How do you get a drug addict to “voluntarily” seek recovery from addiction? For that matter, how do you keep a drug addict clean after treatment if “involuntarily” forced into treatment?
If it’s mandated, doesn’t that mean it’s involuntary?
The way it works now is you can opt-in to programs in lieu of a criminal process. So that wouldn’t be mandatory.
Are we not talking here about solutions to ‘homelessness’ not a criminal process? In other words, doesn’t this go beyond those arrested for a crime?
It doesn’t appear to
If this is just about homelessness via criminal acts – and drug use as such really is hardly a crime anymore – aren’t we usually talking about drug use and treatment as part of punishment for a crime that may have been committed in conjunction with drug use, not drug use itself?
The same option can apply to conservatorships. A condition for involuntary civil commitment is that the individual is unwilling to accept treatment voluntarily.
Yeah, but mental illness and drug addiction are two entirely different animals. They often go together as drugs are often used to self-quell the effects of some forms of mental illness. But treatment for mental health issues and treatment for drug addiction are not even on the same planet. Having people involuntarily committed to a recovery program for drug addiction is a recipe for expensive failure.
Agree. And yet that’s what the Yolo County DA is largely proposing.
I read the sentence to mean the state funding for treatment was mandated, not the treatment, itself. My bad.
Ok, that makes sense.
We were totally stupid to effectively decriminalize drugs and petty theft (which killed off drug court as an option for addicts to avoid jail/prison time and the conviction record). It was far more effective than the “free range” approach we’ve taken to addicts over the last 5 or 6 years. What we SHOULD have done is put more funds in to post release follow up and support and support while incarcerated for those who couldn’t stay clean on drug court programs. Would have slowly drained the prisons of drug users, too.
It’s no kindness to leave them on the streets to slowly kill themselves, spread disease and victimize their communities.
I don’t think the DA’s proposal is intended to be a comprehensive solution. I doubt anybody could come up with a ‘solution’ that solves homelessness, mental illness, and substance abuse. These proposals sound very reasonable to me and the DA acknowledges the hurdles just in getting to these steps. I do acknowledge Eric G’s caveats.
The reality is that it often takes an encounter with the legal system, or a medical crisis or a family crisis, to get people started on recovery. People who quit on their own very commonly report a specific impetus, such as legal consequences.
I suggest you give credit where it is due on this, and address your concerns about more global approaches to those who write legislation and enact it at the state and federal levels.
I agree with DS’s post pretty close to 100%.
David Crosby, amazing-to-still-be-alive former-heavy-drug-user said, “[Prison]’s the only thing that really worked. I had tried going into treatment and it didn’t work. I went into prison, and it worked. It was a s - - tty way to do it.”
I pretty much agree with that.
As with most issues, this is not unique to Davis (or Yolo county).
Apparent increases are also likely a result of de-institutionalization (started decades ago), more recent releases from jails/prisons, increased concerns regarding the rights of individuals to make their own decisions, and increased tolerance for “camping” in places that used to be off-limits (for anyone).
I have to disagree. Of course there’s no single, comprehensive solution. Proposals such as these seem simpler (and cheaper) than developing needed community-based services. But they distract from and prevent directing resources to effective long-term solutions—which involves developing adequate community-based services and supports.
And to Ron: Deinstitutionalization of State psychiatric hospitals, which started in the Reagan era, failed because there were no resources developed in the community. Compare that with the situation with the State developmental centers, which began downsizing and closing in the mid-90s with great success because individuals were moved out only when there were adequate services and supports to meet their individual needs in the community. Community-based services and supports are ultimately less costly, and profoundly improve quality of life for the individuals served.
Eric:
Yolo County services:
Community-based services exist in Yolo County. The problem is: how do you get people into them?
Identifying, addressing barriers to, and motivating people to access available services is part of the problem. But there are also insufficient services (e.g., affordable, supportive housing) to meet the need.
Also, Reisig is talking about addressing the problem statewide, through legislation, not just in Yolo County.
fine with mental health. How do you “motivate” a drug addict to want to stop? Crosby met a way that worked for him.
If prison worked in general, we would not be looking at alternatives at this point.
Plenty of people who are drug addicted enter treatment voluntarily. Intrinsic or external motivating factors vary.
There’s plenty of research on this topic, Eric. Also, many people quit substance abuse on their own without intervention of any kind. Policy needs to focus on those who do neither.
Yes. I’m aware that there’s research.
Yes. And the issue is what that policy is, including what services and supports are developed to address the treatment-resistant population. Doing nothing and utilizing involuntary interventions are not the only alternatives.
Please explain to us how you plan to address the ‘treatment-resistant population’ without ‘involuntary interventions’. Usually that’s why the legal system gets involved in the first place. The services and supports are already there for them to avail themselves if they so choose, be it through county programs, private organizations, or even online recovery options. The list of what Yolo County provides is practically a checklist of community-based services and supports. If you just want to spend more money on the existing programs, just say so. If you think that’s effective, or that Reisig’s proposal is likely to be less effective, please provide evidence.
I think most experts will tell you that the treatment-resistant population is a problem. I also think most will tell you that existing services and supports are woefully inadequate.
I’m all ears 😐
That’s a non-argument. Prisons are where people go when they do stuff, at this point. That’s like saying Hitler invading England isn’t working for England, but we’re looking at alternatives to war, at that point. (Godwin is rolling in his grave, if he’s dead)
It’s not a non-argument at all. If prisons solved drug addiction, we would use prisons and wouldn’t have developed alternatives. They don’t work. In fact, prisons are themselves infested with drugs because people are confined, bored, and there is money to be made for guards and others.
Don — Let’s assume that’s true for Yolo County—i.e., there are adequate supportive housing, including Housing First options, and other needed services for everyone. That’s clearly not the case throughout the state. Yet the DA is proposing expansion of existing involuntary treatment and conservatorship processes throughout the state. This is unjustified and will disincentivize and divert resources from development of needed housing and other services and supports in those underserved counties. Involuntary interventions should be a last resort, not a primary option.
I also agree with Don on this.
You have to understand that in my opinion it’s hard for David to give credit to Reisig for just about anything even when what he proposes sounds reasonable to most people.
I’m not sure how you know what sounds reasonable to most people. However, I’d point out that, at one time, it sounded reasonable to most people that the earth was flat and was the center of the universe.
Well, it seems to sound reasonable to me, Ron, Alan and Don. That’s a good start. 🙂
Difference in approaches. I don’t see an enforcement approach being successful without housing and job training. Given that he is already proposing statewide legislation, why not add those components?
I got up on the Mace Overpass. Looks pretty flat to me.
But another clue is DS, KO, AM & RO don’t often agree on anything. That’s pretty close to a flat Earth.
I don’t think this is enforcement ‘approach’. At first from the headline I thought Resig was somehow proposing an overall solution to homelessness. But really, he’s talking about what to do when people ‘volunteer themselves’ into the criminal justice system.
Money.
So… my “take-away” from the above discussion is, “don’t do anything, until we have a ‘perfect solution’…”
OK, if we and those ‘on the street’ can live with that… but, then again, some say, “life is cheap”… and doing nothing doesn’t cost any taxpayers’ $$$… something from Dicken’s “Christmas Carol” comes to mind… Scrooge saying we’d be better off without them…
OK. But not close to what I was saying. My view is you don’t coerce treatment for an individual and deprive them of individual liberty without first giving that person the option of accepting treatment voluntarily. That means having available, less restrictive alternatives, not a perfect system. The system capacity continues to expand and develop over time.
What are you proposing, an ever-increasing number of government-subsidized rehab centers? That’s gone wonderful in some cities, especially in SoCal where they became a profit-making machine and they were recruiting people from out of state. News flash: the doors of substance-abuse-focused 12-step programs are open and free all over town, every day of the week.
Isn’t that also what Reisig is proposing?
Hmmmmmm . . .